ID

24685

Description

Study part: Ambulatory Blood Pressure Monitoring Diary. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Mots-clés

Versions (1)
  1. 13/08/2017 13/08/2017 -
Détendeur de droits

GlaxoSmithKline

Téléchargé le

13 août 2017

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0
Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Retour au modèle Commentaires
Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

Ambulatory Blood Pressure Monitoring Diary Restless Legs Syndrom NCT00355641

Anglais

Ambulatory Blood Pressure Monitoring Diary

1 Formulaires  
General Information
Description

General Information

Alias
UMLS CUI-1
C1508263
Visit week
Description

Visit week

Type de données

integer

Alias
UMLS CUI [1]
C0439230
Doctor’s Name:
Description

Physician name

Type de données

text

Alias
UMLS CUI [1]
C2361125
Telephone Number:
Description

Telephone Number

Type de données

integer

Alias
UMLS CUI [1]
C1515258
Study Contact:
Description

Study Contact

Type de données

text

Alias
UMLS CUI [1]
C0337611
Subject Identifier
Description

Subject Identifier

Type de données

text

Alias
UMLS CUI [1]
C2348585
AMBULATORY BLOOD PRESSURE MONITORING DIARY
Description

AMBULATORY BLOOD PRESSURE MONITORING DIARY

Alias
UMLS CUI-1
C0430452
Date of assessment:
Description

Date of assessment

Type de données

date

Alias
UMLS CUI [1]
C2985720
Arm
Description

Arm

Type de données

text

Alias
UMLS CUI [1]
C1140618
What time did you take your study medication:
Description

Please record time to the nearest minute.

Type de données

time

Unités de mesure
  • min
Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C0013227
UMLS CUI [1,3]
C1512806
min
Activity at time of Blood Pressure Measurement- Pre-dose
Description

Blood Pressure Monitoring Ambulatory Pre-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439565
1 Hour Post-dose
Description

Blood Pressure Monitoring Ambulatory 1 hour post-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439571
2 Hours Post-dose
Description

Blood Pressure Monitoring Ambulatory 2 hour post-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439572
3 Hours Post-dose
Description

Blood Pressure Monitoring Ambulatory 3 Hours Post-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439573
4 Hours Post-dose
Description

Blood Pressure Monitoring Ambulatory 4 Hours Post-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439574
5 Hours Post-dose
Description

Blood Pressure Monitoring Ambulatory Post-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439568
6 Hours Post-dose
Description

Blood Pressure Monitoring Ambulatory Post-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439568
7 Hours Post-dose
Description

Blood Pressure Monitoring Ambulatory Post-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439568
8 Hours Post-dose
Description

Blood Pressure Monitoring Ambulatory Post-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439568
9 Hours Post-dose
Description

Blood Pressure Monitoring Ambulatory Post-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439568
10 Hours Post-dose
Description

Blood Pressure Monitoring Ambulatory Post-dose

Type de données

integer

Alias
UMLS CUI [1,1]
C0026426
UMLS CUI [1,2]
C0439841
UMLS CUI [1,3]
C0439568
Retour au début de la page

Similar models

Ambulatory Blood Pressure Monitoring Diary

1 Formulaires
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
General Information
C1508263 (UMLS CUI-1)
Visit week
Item
Visit week
integer
C0439230 (UMLS CUI [1])
Physician name
Item
Doctor’s Name:
text
C2361125 (UMLS CUI [1])
Telephone Number
Item
Telephone Number:
integer
C1515258 (UMLS CUI [1])
Study Contact
Item
Study Contact:
text
C0337611 (UMLS CUI [1])
Subject Identifier
Item
Subject Identifier
text
C2348585 (UMLS CUI [1])
Item Group
AMBULATORY BLOOD PRESSURE MONITORING DIARY
C0430452 (UMLS CUI-1)
Date of assessment
Item
Date of assessment:
date
C2985720 (UMLS CUI [1])
Arm
Item
Arm
text
C1140618 (UMLS CUI [1])
time medication intake
Item
What time did you take your study medication:
time
C0040223 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C1512806 (UMLS CUI [1,3])
Item
Activity at time of Blood Pressure Measurement- Pre-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439565 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
Activity at time of Blood Pressure Measurement- Pre-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Item
1 Hour Post-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439571 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
1 Hour Post-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Item
2 Hours Post-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439572 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
2 Hours Post-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Item
3 Hours Post-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439573 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
3 Hours Post-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Item
4 Hours Post-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439574 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
4 Hours Post-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Item
5 Hours Post-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439568 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
5 Hours Post-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Item
6 Hours Post-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439568 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
6 Hours Post-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Item
7 Hours Post-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439568 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
7 Hours Post-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Item
8 Hours Post-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439568 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
8 Hours Post-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Item
9 Hours Post-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439568 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
9 Hours Post-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Item
10 Hours Post-dose
integer
C0026426 (UMLS CUI [1,1])
C0439841 (UMLS CUI [1,2])
C0439568 (UMLS CUI [1,3])
Blood Pressure Measurement Pre-dose
Code List
10 Hours Post-dose
CL Item
Sedentary (or not very active) (For example, napping, reading, watching TV, listening to music, etc.) (1)
C0205254 (UMLS CUI-1)
(Comment:en)
CL Item
Low (activity) (For example, using computer, cooking, eating, etc.)  (2)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (activity) (For example, shopping at the mall, walking at a comfortable pace, etc.) (3)
C0851791 (UMLS CUI-1)
(Comment:en)
CL Item
High (activity) (For example, running, cycling, etc.) (4)
C0851792 (UMLS CUI-1)
(Comment:en)
CL Item
Device not worn (5)
(Comment:en)
Retour au début de la page 

Contact

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Aide

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial